


Mariposa

by YaminoTenshi202



Series: Hydrangea [2]
Category: Voltron: Legendary Defender
Genre: Child Abuse, Childhood Sexual Abuse, Childhood Sweethearts, Childhood Trauma, F/M, Homelessness, M/M, Medical Professionals, Mental Health Issues, Orphan Keith (Voltron), Research, someone save keith
Language: English
Status: In-Progress
Published: 2019-03-14
Updated: 2019-04-02
Packaged: 2019-11-17 23:57:23
Rating: Mature
Warnings: Graphic Depictions Of Violence, Rape/Non-Con, Underage
Chapters: 2
Words: 9,316
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/18109127
Author URL: https://archiveofourown.org/users/YaminoTenshi202/pseuds/YaminoTenshi202
Summary: After Keith's father left, he stayed out in the desert. When two strangers came, he was clutching his belly. They were the first two people he had ever seen aside from his parents...And he'd see them later, too.





	1. Breech

**Author's Note:**

> This would be the story immediately following Oasis. "Oasis" finishes 2 years prior to the beginning of this story.

Dr. Price had not been surprised by the chief complaint listed on his patient assignment list for the patient in room 12. It wasn’t a rare occurrence to have a child come into the emergency room with heat exhaustion and a urinary tract infection. That was common enough in Arizona. He was surprised at the condition that h saw the child in when he walked into the room at noon.

He sighed as he left the room. The two men that had brought the boy in had been very concerned, assisting with holding him when they were putting in the IV and even during the insertion of the urinary catheter. He had thanked him when they left, making sure to record their names to have as part of the child’s history.

It was just past two in the afternoon when he sat down to complete his patient history and physical, and Dr. Price wondered what would happen after his medical state had stabilized.

* * *

**Physician** : Price, Delma

**Date/Time** : September 6, 2XXX, 1406

**Time spent with patient** : 40 minutes

**Patient Name** : Doe, John

**History and Physical** : A complete history is unavailable due to patient being unable to complete a reliable history and/or is currently non-verbal. The patient is a young male patient, estimated to be four or five years old. He is currently being identified as “John Doe”. He presents to the ED with dehydration, heat exhaustion, and a urinary tract infection.

He was found by two men who had been travelling through the desert. From their reports, the child had been seen through the windows of an old shed. When the two began to approach, the child hid himself. After entering the shed, they found the child trying to lift a basement door. Since then and even upon admittance to the emergency room, the child has been non-verbal, shouting and growling. He has been guarding his lower abdomen, occasionally moaning. Patient was complacent when held by one person at a time, tolerated IV insertion fairly.

No family members have been identified at this time, and no other medical history has been discovered on this boy. Child Protective Services has been contacted. Child sedated with ATIVAN 0.8 mg IV ONE TIME ONLY for anxiety, TYLENOL 160 mg ONE TIME for mild pain/fever. Indwelling catheter inserted for accurate I&O.

**Allergies** : No Known Allergies

**Family** : Unknown History

**Review of Systems** : 

  * General: Patient is non-verbal but looks to staff when they speak. Patient did arrive clothed to the ED, though clothes have holes and are covered in dust. When staff is soft-spoken, patient relaxes visibly. Does seem calmer being held by staff members. Ribs visible bilaterally upon inspection.
  * Pain: Patient moans, guards abdomen.



**Physical Examination**

  * VS: 101.3 F, Pulse 103, Respirations 25, Oxygen saturation 99% on room air, BP 97/50, Weight: 35 pounds, Height: 42.3 inches (Weight and Height may indicate malnutrition once age had been determined)
  * General: Patient is sedated. When awake, hypervigilant. Oriented only to self. No edema.
  * HEENT: Normocephalic, PERRLA, face is symmetrical. No discharge noted from eyes, ears, nose, mouth. Conjuctiva are pale, moist. Lips dry. No wounds to scalp. Hair is clean.
  * Neck: No swollen lymph nodes, no adenopathy. No JVD. Carotid pulse +3.
  * CV: Regular, tachycardic. S1, S2 sounds. PMI non-displaced.
  * Pulmonary: Regular, non-labored. No sign of paradoxical breathing. 
  * Abdomen: Soft, distended, active bowel sounds. RLQ, LLQ tender. Liver, spleen non-palpable.
  * Pulses: Fem +3. Pedal +3. Radial +3.
  * Extremities: No cyanosis, pink, warm. Nail beds pink, 3 sec cap refill.
  * Musculoskeletal: Active. Movement, tone intact in all extremities, trunk.
  * Genitourinary: No injuries to genitals. Indwelling catheter in place. Urine cloudy, amber, concentrated.
  * Integumentary: Skin shows no evidence of sunburn, no erythema. Scars are generalized over patient’s body, possibly of animal origin due to multiple parallel scars on forearms and legs. No pressure ulcers. Mark on back of the neck, appearing to be similar to a tattoo, intricate design.



**Labs, Imaging, Etc** : 

  * Na **126** (135-145)
  * Cl 106 (95-105)
  * BUN **30** (2-25)
  * Glu **115** (70-100)
  * K **2.9** (3.5-5.0)
  * CO2 25 (20-28)
  * Creatinine **1.5** (0.12-1.06)
  * WBC **14.85** (4-10)
  * PLT 400 (150-400)
  * HgB **10.5** (11.5-15.5)
  * Albumin **2.9** (3.7-5.5)



KUB: Indwelling catheter in place. Hydronephrosis is present bilaterally.

Head CT: No cerebral changes that would differ from a child of his age. No acute processes.

Urine cultures, blood cultures - drawn

**Assessment:** This is an extreme case. The child may not be capable of speech and may be a victim of neglect and/or abuse. The child is malnourished and presents with dehydration, fever, and urinary tract infection. How he was surviving in the desert is inexplicable at this time.

**Plan:**

  1. Renal: Urinary tract infection with hydronephrosis. Possible surgical intervention due to extent of hydronephrosis. 
  2. Infectious disease: 800 mg ROCEPHIN, IV, Daily for UTI. Urine cultures collected with indwelling catheter. Blood cultures drawn, x 2.
  3. Nutrition: Malnourishment. Speech therapy ordered. Dietician to see patient.
  4. Possible activity intolerance: Physical and occupational therapy.
  5. Fluid deficit: Normal Saline with 10 mEq of KCl IV fluids running at 40 mL per hour, maintaining minimal urine output (in 24 hours) to be 400 mL. Intake and output to be strictly monitored and recorded, using indwelling catheter.
  6. Psychological: As the patient recovers medically, he will be psychologically evaluated to determine if there is any delay in linguistic ability related to his isolation. There is still a possibility of abuse that may be the cause of his scars, the mark on his neck, and his current condition. Social conditioning may be put as a final obstacle to overcome as his condition improves.
  7. Disposition: It is unknown how long the child will be in the hospital as inpatient. Police and CPS is now involved and will find out information in regards to the child’s identity. From there, we can determine a possible plan for when the patient leaves the acute setting.



**Consults:** Dr. Magdalena Martinez - pediatric medicine; Dr. Esmond Peterson - psychology; Dr. Khloe Rogers - urology; Dr. Salome Cox - infectious disease

* * *

David sighed as he finished his note. A lot had happened in just the hour that he had his new patient. The pediatric unit was not as noisy as it could be on some days. However, all it meant was that they could focus on their new patient.

“Dave, should I try to feed him anything yet?”

“Sarah, we’ll just wait for the speech therapist.” He knew that the assistant was worried for the boy. She had her own son at home, four years old. Dave had his kids years ago, all grown now, so he had enough practice with putting the kids’ needs above what would make him comfortable.

Sarah sighed, leaning on the counter at the nurses’ station.

“It’s not like he’ll get hurt from not eating, Sarah.”

“... Do you think they starved him?”

The air turned sour. It was something that unsettled all of them. They’d all seen some frightening things happen to their patients, things that sent them here. On awful occasions that sometimes left them sleeping poorly, they’d send their patients back there.

“We’ll find out in time.” David stood up, grabbing his tablet and walking into John Doe’s room.

* * *

**Progress Note** \- September 6, 2XXX, 1530 - Porubs RN, David 

Patient admitted to floor at 1425. Patient looking all around room. Non-verbal but seems to understand English, though full understanding is yet to be determined. Responding well to complex commands, possibly due to more peaceful environment of the pediatric unit. Heart monitoring put on patient, NSR. Pulled at catheter once but is now only grimacing when staff draws attention to it. Not pulling at IV for now, patient has armboard for IV in right arm. Dr. MARTINEZ placed orders for speech therapy, currently NPO, IV fluids switched to D5 0.45% NS with 10 mEq of KCl running at 40 mL per hour.

* * *

John was a cute little boy. David had wondered if he had gotten the wrong patient initially. John’s inky black hair made it down to just below his hips. Gray-violet eyes were wide and round, the light in them only making his gaunt face more apparent. At first, John was trying to get out of bed. After David gently chided him, John sat still and let David assess him with little more than occasionally grabbing the stethoscope. 

David carefully went over everything in the room, using simple words to describe the call light, the bed, and the television. John ignored the devices, something that could usually hold a child’s attention, in favor of the blankets and pillows that were on the bed. He rubbed his face into a pillow, humming and laying down upon it.

Having the child acclimated to the room, David had gone to the station to type his report at the computer after charting on his tablet. From his spot where he had been talking with Sarah, David could see that John was just laying in bed on his pillow perch, playing with the call light cord. 

“Hey, David!” David turned to another assistant Allen.

“Hey.”

“For the new little tyke, you should see what I put under your desk.”

David smiled, reaching under his spot at the desk to grab some things. When he returned to the room, John seemed surprised. He sat upon his haunches and stared at the nurse.

“Well, little guy, how about we play a game?”

“...” John stared.

David set about to setting up the stuffed animals that they had on John’s bed. Three animals sat there: a lion, a rabbit, and a wolf.

“You can be one, I’ll be the other two.”

John’s eyes were transfixed on the rabbit. After a moment that lasted hours, he looked to David, reaching his arm out for the rabbit. David nodded. John bolted for the toy, David softly cursing as the boy almost pulled out his IV and catheter.

John had the rabbit, tight and secure. As David reached for the other two, John grabbed the wolf and began to make small howling noises. They were rather… convincing, if the shiver going up and down David’s spine meant anything.

But it gave him some hope, because now David could see that John wasn’t completely a feral child; like all cared-for children, John could pretend.

* * *

**Progress Note** \- September 6, 2XXX, 2324 - Porubs RN, David

Patient is content in room. Worked with speech therapy. Pureed diet. Thickened liquids for now, nectar thick. Ate only 25% of food, drank juice and lemonade from bottle. Using hands to eat, to explore. Was given a sponge bath in unit washroom after dinner, surprised by warm water in the basin. Initially anxious during bath but gradually acclimated to washing. Grabbed washcloth from nurse to clean legs, peri care. Antibiotic given. IV fluids continue. Catheter care completed. Patient went to sleep at 2200. Vitals check at 2310 revealed fever of 100.5 - PRN PO TYLENOL given.

* * *

David had thanked Cory for coming to see John so quickly. From the speech therapy session, John could eat purees and drink nectar-thick fluids. Not terrible for a first time.

John liked to mash his food on the roof of his mouth with his tongue. When they had brought him a puree of burger patty, John took to it swiftly, eating half of it before trying his puree cookie and vegetables. David had been somewhat off put by the bottles of juice and lemonade but Cory had assured him that it was best.

“I tried to spoon-feed him water. John couldn’t figure it out. He spilled the water and just sucked on the spoon.”

“He couldn't use a straw?”

Cory shook their head, going on, “He couldn't wrap his lips around it well. He tried once and started coughing.”

David nodded, turning to John who was grabbing the puree with his fingers. David grabbed the boy's hands. John whined at him.

“You're going to use a spoon, John.” The boy's brow furrowed as David put a spoon in his little hand, closing his fingers around the handle. With care, David began to help John feed himself.

Cory smiled, waving to them both and dismissing himself. David waved back as John swallowed his first pureed cookie.

When John had his fill of solid food, David held up the bottle of thickened apple juice to the boy's lips. Automatically, John opened his mouth. David watched as John's mouth wrapped naturally, accurately, around the synthetic nipple. He watched as John's little cheeks fluttered with his suckling.

After a little while, John pulled away from the bottle, licking the last of the juice that had beaded up on the nipple. He reached for the other bottle, which David offered him.

“You thirsty little thing…” the nurse whispered, holding John to his side as John got used to the taste of the lemonade. The boy wrinkled his nose at first but settled into that taste, resting on David's side.

After a bath which left John flabbergasted, David found his heart breaking. John had licked at his arms after dinner, a habit that David had put a stop to. In the washroom, John had been gently disrobed, something the boy didn't seem to mind at all. Sarah had brought everything they needed, even a shower chair, and had warmed the water beforehand. John had watched and listened as David and Sarah explained what they would do. 

Washing such long hair was a task that David didn't find himself familiar with. Thankfully, John was patient, almost falling asleep in his little shower chair as his head was massaged and washed. When Sarah washed his legs, John squirmed. He seemed to mind the urinary catheter as he wriggled. Sarah bit her lip, hiding a smile as she cleaned the bottom of his feet.

John let out a choking noise from his throat, lips pouting into a slight grimace. He shivered, gooseflesh travelling up his body. The choking noise soon gets a voice behind it, almost a laugh. Sarah pulled away when she was done, but John whined.

“What's wrong, honey?” John didn't answer her, grunting as he tried to relax again.

“I know you can talk in that little head of yours,” David urged him, but John didn't respond. He hummed softly as he poured warm water over John's skinny body. He tried not to focus on the ribs or vertebrae that he counted.

When David told John that he would wash between his legs, John reached out.

Sarah sat up, frowning.

“What? What do you need, John?” she said, looking for what he could want.

“John- Hey,” David warned after John slapped his hands away from his body. John continued to reach for their washcloth or soap or elsewhere, target always changing.

Understanding, Sarah dipped her new washcloth in warm soapy water again, wringing it out before handing it to the boy.

“Clean between your legs, doll,” she encouraged. John carefully stood up from his perch with David's help, dragging his clothes clumsily over his groin.

“Nice catch, Sarah.”

“And the bosses still don't pay me enough. I swear, with his sharp eyes, he's definitely talking to us.”

When John was sufficiently clean, judged under his caretakers’ careful eyes, Sarah handed him a wet clothes for rinsing. John repeated the process as David took care of the catheter, talking to John to distract the boy from what obviously had bothered him before.

Rinsing him one last time with warm water, David and Sarah bundled up John in towels, quickly drying and dressing him. With a warm blanket to keep John from getting cold, they made it back to the room.

John was gently tucked into bed, his new stuffed rabbit smashed against him on one side. His fingers were tangled in David’s scrub top. David felt a gentle motion against his side after a few moments. John's eyes were almost closed, eyes focused on the opposite wall. The soft rubbing had come from John's hand, as though he was petting David.

“What happened to you?”

John fell asleep. David only woke him once during the night to give him acetaminophen for his fever when they checked his temperature at 11 pm.

* * *

**Progress Note** \- September 7, 2XXX - 0538 - Bailey RN, Hana

Patient awoke crying around 0200. Agitated, pulled at IV tubing but left it alone when staff entered the room. Did not attempt to pull at urinary catheter. Allowed comfort from RN, receptive to hugs. Reaching for bottle with water, but did not wish to drink. Suckled on own fingers, thumb; blood seen but no wounds seen on patient. Dr. MARTINEZ contacted, 0.8 mg ATIVAN as needed through IV to allow patient to rest. ATIVAN given, patient asleep, still arousable during assessments but drifts to sleep again. Lab techs in to draw blood, patient held by one tech during blood draw. Patient did not resist lab draws, was watching lab techs during procedure. Does not appear bothered by sight of blood. Back to sleep this morning.

Urine output at midnight: 120 mL

* * *

Hana had expected an easy night when David told her how calm their little John Doe had been during the afternoon. She should have known better, but she had been hopeful.

John was inconsolable, trying to climb out of bed once she had come into the room. She had managed to save the IV, thank goodness. Hana was shocked to see blood on the sheets.

“Baby, what happened?” John only whimpered at Hana, weakly struggling against her as she prodded at him all over. Hana looked all over for a wound, but she saw nothing. She did see some scabs on John’s fingers, but she couldn’t tell how old they were in the light. She saw him reaching for his bottle that they had filled with water for the night. Holding it to his lips, John didn’t try to drink. He just held the nipple in his mouth. He did cough when some water went into his mouth by gravity.

Hana hushed him, cooing at John. He was shaking like a leaf, clawed fingers in her scrub top. Hana wrapped her arms around the little boy, rocking him gently. She hummed softly to him, some tune that she had heard her mother sing to her when she was small. John suckled on his fingers, face still contorted by a stubborn frown. 

As they sat in the dim light of John’s room, Hana saw him squirm more often, eyes frantically looking around the room. It wasn’t just restlessness. As his whimpers became more numerous and he began to scratch at himself and even towards her face, Hana sighed, grabbing his little hands.

“No, baby. You’re not going to scratch me.”

The boy let out a cry, one so heartfelt that Hana wanted to cry. She didn’t know what he wanted or what he needed. He looked tired, though. He was tired, frightened, and he looked like he would tear down anything standing between him and freedom from Hanna's grip.

“How about we get you something so you can sleep?”

She had an aid come in, and John didn’t change his actions at all, even when they took vitals. Hana left the room, John sobbing. Hana called Dr. Martinez.

“Hello, Dr. Martinez. I’m sorry for calling you so late.”

“ _ No, Miss Hana. I was expecting a call tonight. I’m just surprised it wasn’t sooner. Is it about little John? _ ”

“Yes. He’s been crying and shouting non-stop for the last thirty minutes. He wasn’t thirsty. I saw some blood on the sheets, minimal, but I didn’t see any open wounds anywhere.”

“ _ How were his vitals? _ ”

Hana listed off the vitals, almost disappointed that they were all within normal limits. She explained how he got more and more restless with their gentle care of him. He at first wouldn’t pull away but then began to scratch at himself and Hana.

“ _... Give him Ativan. 0.8 mg of Ativan as needed for anxiety and severe restlessness every 6 hours. We’ll keep a close eye on him tonight. _ ”

“IV Ativan, right?”

“ _ Yes. Let’s keep an eye on him. I’m wondering more about his history and living conditions. From what I was told in my report, two adults had found him in a shack in the desert. Apparently, it looked like no one else had been there in years. Dr. Chauny will be in tomorrow to see him. _ ”

Hana bit her lip, thanking the physician and bidding her good night.

* * *

**Progress Note** \- September 7, 2XXX - 1145 - Tyler RN, Harrison

VSS, afebrile. Patient labs improved steadily. BUN 32 (previously 25, worse today), Sodium 130, Potassium 3.0. Potassium 20 mEq rider given per Midline IV in right upper arm, started at 0630. Patient was playing with IV tubing today, but not pulling at Midline. Tylenol given for abdominal pain. He’s tolerating pureed diet and drinking from bottle. He’s making no attempt to suck from straw or drink from cups. He’s tolerant of blood draws from the lab technicians. Sponge bath today, catheter care completed. 

* * *

Harrison watched as John played with her badge, letting her get a chance to listen to his lungs. She had given him some Tylenol for his belly, based on the fact that John kept curling onto his side and guarding his stomach before. He had broken his fever yesterday, which made things a bit simpler. He was curious in playing today.

“Here, play with your rabbit.” Harrison held out the rabbit plush, watching and observing as John reached out for the soft animal. In her mind, she made a record of his movements, his skills, and the fact that he still made no noise that could be taken as human speech. They sounded like the noises that her pet cat would make at home.

When breakfast had come, Harrison had given him some cereal, but John had choked on even the thickened milk. When Harrison had offered him the bottle with milk, he had turned away. Insistence on the milk was met with resistance, so Harrison had set it off to the side. Hopefully, John would be willing to drink milk at lunch here shortly.

A knock came at the door. The lab technician introduced herself as Lilly, a familiar face that had Harrison’s heart skip.

“Hey, love. I’m here for a CMP.” Harrison nodded. John watched the tech as she came close.

“What’s your name, sweetie?” Lilly asked, looking up to Harrison just in case.

“Doe, John.” Harrison provided the first day of the year, five years prior, as his assigned birth date stated. Lilly thanked her and moved her focus to John.

“What a curious little bun.” Lilly watched John’s eyes as they watched her flutter about her cart. “John, what color of bandage do you want?”

John looked up at her and then down at the rolls of bandages that she had for him. Harrison looked at Lilly expectantly.

“I heard from one of the other techs that this little guy is a nice one. He deserves to pick his own.”

Of the blue, red, and yellow that she put in front of him, John grabbed the red one. Lilly put the others away. Harrison watched John grab the bandage roll, the cohesive fabric a different texture on his fingers that he examined enthusiastically. Lilly hummed as she got her equipment ready.

“Any reason we’re still sticking him?”

“Just in case the midline hurts at all, we don’t want him to associate it with pain. He might pull it out.”

“Of course,” Lilly conceded, pulling on her gloves. She turned to John, who stared up at her with sparkling eyes. She directed him with his arm placement, letting Harrison keep a firm hold of him and his arms.

“Ah,” John sounded out as Lilly put the tourniquet on.

“You’ll feel a little poke, baby,” Lilly said as she cleaned the spot where she decided to pierce the boy’s skin. John watched her, hawk-like as Lilly got ready. Harrison took John’s other hand, squeezing it gently. John returned the gesture. 

Harrison was surprised that John didn’t pull away from Lilly. He watched as his blood was drawn. He looked up at Lilly and back to his arm, his little hand squeezing the adhesive bandage roll again.

“You did great, honey.” Lilly beamed up at the boy from her low perch, taking his hand with the bandage roll and gently unrolling what she needed from it. With his arm bandaged, John took to touching his arm, letting go of Lilly’s supplies.

“I don’t think I’ve ever seen a little kid obsessed with how a person draws their blood.” Lilly took off the tourniquet and smiled at the boy and nurse both. “Maybe he’ll be one of us in the field one day.”

“Who knows?”

* * *

**Progress Note** \- September 7, 2XXX - 1630 - Murphy RN, Rachel

VSS, afebrile. Potassium up to 3.5. Sodium 130. Patient isn’t looking for toys or other diversions. He tolerated pureed diet for lunch and snack. He is still drinking from bottles. He has taken to observing staff. He stopped his IV pump at 1600, watched as Murphy RN restarted it. Murphy RN advised patient not to touch IV pump. Patient looked at RN and reached for pump, waiting. RN told him not to touch the pump again. Patient has not touched pump while RN was at nurse’s station, watching the room. CNA Allen K. did find stuffed animals for the patient yesterday, and the patient has been holding onto a stuffed rabbit.

* * *

**Progress Note** \- September 8, 2XXX, 0253 - Porubs RN, David

Patient crying again this night. Still non-verbal. Awoke from sleep without external stimulus. Reached out for pillow, stuffed animal at bedside. Is receptive to comfort from staff (David Porubs, RN, and Silia Vera, RN). Attempting to calm self, crying to stuffed animal.

Urine output at midnight: 150 mL

* * *

On September 8th, the third day of John Doe’s admission, Dr. Magdalena Martinez came in with several things that she had gathered from the thrift store not far from her home.

“You’ve never done this for a patient,” her husband Adolfo had said. Magdalena had shrugged.

“I don’t think I’ve ever had a patient with absolutely nothing before.” Magdalena had seen children suffer abuse but they had objects with them at least. There were toys and other trivialities, though the children held onto them like liferafts. Children that suffered neglect were often hiding away inside of themselves, but once they were provided a regular schedule for their needs, they would slowly open up as they finally would learn to trust again.

Their little John, as she liked to call him, having read his pseudonym on her patient list and thinking of Robin Hood, was clinging to the staff, eagerly seeking contact. He never turned away the food that he was given, and his crying only came at night. He had been inconsolable only on the first night. Perhaps he was having nightmares or he was recalling some danger that he would face at night.

“Good morning, Dr. Martinez,” a nurse greeted her brightly. She was a young one, Miss Harrison.

“Good morning, Miss Harrison. Do you know who has little John Doe today?”

“I have him again today, missum. However, I heard that the sheriff is going to be coming in today. He has some information about John.”

“Let’s go in then.”

Magdalena found herself staring down at John Doe. His gray-violet eyes followed her the moment she went into the room. They glanced down momentarily at her bag before seeing her face.

“Hello, John. How are you doing today?”

John’s lower lip pouted out slightly. He didn’t answer. He decided to focus on the bag, trying to discern anything from it.

“I’ve brought some clothes for you. Would you like to try them on?” Magdalena sat down on the hospital bed, letting her patient crawl over to her. John stared into the bag, a plush animal at his side. As he reached into the bag, Magdalena grabbed her stethoscope.

“I’m going to listen to your back.” John grabbed the stethoscope from her grasp, brought it to his nose, and gave it back once he lost interest. He kept his hands in the bag of clothing as the doctor went about her business, Harrison keeping an eye on the two of them.

John pulled out a long shirt, black and gray stripes over it. He felt over the fabric, mesmerized by the feeling with how he dragged his fingertips over it. Magdalena watched as he tried to move out of his hospital gown.

“Do you want to put the shirt on?” John looked up at her and then the shirt. He held it out to her, eyes pleading but patient. Magdalena asked Harrison to remove the order for heart monitoring from the computer system as she removed the wires and monitor. She gently guided John out of the gown and into the shirt. It reached down to the mid-length of her patient’s thighs, almost like a dress.

“There we go. Now you look more comfortable.” Magdalena continued assessing him, watching John communicate with his stuffed rabbit with little hand movements and chirps.

“It seems like you’re getting better, little guy,” she assured him, wondering how much he was processing of her words. He would watch her movements. He had found something that he had liked and was able to communicate well with her, pleased when he got what he wanted.

Magdalena lifted her head up, looking to Harrison when a knock came at the door. Harrison left her tablet for a moment, and in came someone that Magdalena had been anxiously waiting for.

“Sheriff Bell.” She shook his hand when he approached, Sheriff Bell thanking the doctor and the nurse for their time.

“Miss, Doctor.” His attention turned to the boy, his hands on a black suitcase. “Hey, buddy.”

The boy stared back.

“Can he understand me?”

“You’d be surprised, sir. You can talk to him normally. He’ll let us know what he understands,” Harrison assured him.

“Well, then.” Sheriff Bell knelt down to meet those curious little eyes, keeping their gazes locked.

“What’s your name, buddy?”

“...”

“Is it Keith?”

Magdalena watched as her little patient sat up straighter, eyes focused on Sheriff Bell with a fire that Magdalena had not seen in him before.

“Are you Keith Kogane?”

Keith nodded.

“When’s your birthday, Keith?”

“... Twenty-three… October.” The voice that came out of the boy was cracking. It had not been used during the previous days of admission, but it had been buried for such a long time. Perhaps the desert had taken that voice away, but it left the bare bones of it. There was a melodic quality to the boy- Keith’s voice, though it was still so soft.

The sheriff looked to both Magdalena and Harrison. Both women nodded, encouraging him to continue.

“How old are you, Keith?” Keith looked away from the sheriff, down to his rabbit. He placed the stuffed animal on his lap.

“... Why?”

“We were wondering, Keith. I thought you were five years old,” Magdalena explained, “Was I right?”

“... ‘m seven.” Keith pulled at his shirt, avoiding everyone’s eyes now.

“Thanks for telling us, Keith,” the sheriff praised, “It’s pretty hard telling us when you haven’t seen people for a long time, huh?”

Keith nodded, pressing against Magdalena’s side. He was trying to disappear, but Magdalena wouldn’t let him, not when Keith was finally talking.

“It’s okay, Keith.”

“No,” he warbled out, voice still so fragile.

“Why is it not okay?” asked Harrison, coming close to be near Keith’s eye level.

“Pa!” he cried out, looking up at Harrison, Magdalena, and Sheriff Bell. “Where’s Pa?”

“You mean your daddy?”

“Pa,” Keith replied. He nodded, gripping onto the sheriff’s sleeve. “You know where Pa is?”

The sheriff, old in years but still rather soft-hearted, turned away for a moment, taking in a deep breath and sighing.

“Keith, you need to rest. I can tell you about your daddy later-”

“No! Where’s Pa?!” Keith’s voice was hoarse, a cough erupting from his throat from such disuse.

“Sheriff, it might be best if we tell him now,” Harrison advised. She turned to Keith, who took longer in facing her. “Keith, the sheriff will tell us, but you need to listen, okay? Be quiet, wait for the sheriff to finish talking.”

“Okay.” Keith held out a pinky in offering to Sheriff Bell, missing the glare that he gave the young woman.

“It’s best,” Magdalena assured him.

Sheriff Bell nodded, pulling out a folder from the briefcase. Magdalena froze, gripping Keith to her body, as the familiar folder of a death certificate made itself known to her.

“What’s your dad’s name, Keith?”

“Akira… Kogane.”

Sheriff nodded, and he opened the folder where an obituary was on the top of the files inside. Keith squirmed as Magdalena’s arm grew tight around him. She would not object to him hiding now.

“Pa!” Keith smacked his hand down on the photo, eyes lighting up and his whole posture jumping up with excitement and such longing. “Fought fire…”

“Yeah, he’s a firefighter, right- Dr. Martinez?” Magdalena had stopped the sheriff with a shake of her head.

“Keith, how about you rest for a while?”

Keith's dark eyes looked up at her. She had wondered what some of the nurses had meant with Keith's eyes stalking after them like an animal. There was an understanding there that she hadn't expected, something that knew that she wanted to hide something from him. Keith turned to the paper, and he dragged his hand lower.

“My Pa…” Keith grew stiff, Magdalena joining him on instinct.

“He died?” Sheriff Bell blinked, staring down at Keith.

“Can you read, Keith?”

“Pa died?” Keith grabbed the paper, eyes scanning over it. Magdalena held a firm grip on him as Sheriff Bell tried to grab the obituary. When the sheriff got a hold of it, Keith let go.

“I’m sorry, Keith. Your dad died on the job, fighting a fire. That was more than two years ago.”

Keith looked up to the sheriff and then to the doctor. He pulled away from them both, pulling his stuffed rabbit into his arms.

What was Magdalena to do?

“Keith-”

“No!” Keith pulled away from his doctor, climbing down from the bed. Harrison caught him just as he was pulling on the catheter. Sheriff Bell gathered his information, tucking it onto a bedside table while he helped wrestle Keith onto the bed.

Magdalena went to the door, calling for another nurse to bring her the anxiety medication that she had ordered for the unknown patient.

“Now,” she almost shouted, coming back to see Keith making claw marks in the air. 

Magdalena couldn’t hear anymore words or thoughts from the boy. When she got a look at those eyes, the ones that had looked at her with hope that perhaps this Akira Kogane was alive, she had gotten soft. The Keith that was punching her was trying to get away from the people keeping him safe, trying to get him better.

Magdalena grabbed his arms. Surprisingly, when Keith kicked at them, the sheriff almost bowled over, needing time to recover. The second nurse that had been called for came into the room, sedative in hand.

The next moments were a blur. Keith was shouting at them, no words but the same growls and cries that had greeted them in the emergency room. Harrison held down one leg, the sheriff the other, and they turned him onto his side. Magdalena shuddered as the second nurse got the sedative ready, faster than Magdalena could truly process, and stabbed the needle into the muscle of Keith’s thigh.

After a short eternity, Keith stopped struggling, the anxiety medication running through him. His eyes closed. Magdalena was left with a sleeping child in her arms.

“Dr. Martinez,” Harrison whispered, “as soon as Keith fights off this infection and starts eating, we need to get him to psychiatric care.”

“I’ll try and find if this kid has any family,” the sheriff offered. “It might help.”

“I’ll talk to his case worker,” Magdalena uttered out. She pet Keith’s hair, wondering what he had hoped for before they told him the truth. With a whimper, he pulled away from her touch.

Magdalena went home that night, trying to forget that this case had ever happened.


	2. Nurture

**Summary for the Chapter:**

> Keith interacts with children outside of a hospital setting and celebrates his birthday.

“Are you ready, Keith?”

Keith turned to the voice at the doorway. His social worker stood there with a smile of pity for him. He shrugged, at which she scoffed.

“Do you have everything?”

“I don’t have much.” Keith looked to his backpack and suitcase. In the months since he’d gotten out of the hospital, the police had managed to gather a few things from the shack that had been his home. A deed had been found, leaving him the small building when he turned eighteen. There were some fingerless gloves that Keith had that he would use when trying to make traps to catch wild game. They had also found Sego, his only friend besides-

Keith squeezed the stuffed rabbit that the hospital staff had given him when those strangers had brought him to the hospital in the first place. It had been September then, and it was now July.

Sego was safe in his backpack, the rabbit in his arms, and his social worker grabbed his suitcase. He grabbed the hand that she offered to him, following her to her car.

On the way, none of the other children in the group home said good-bye to him. The only ones that would care would be the toddlers and babies that Keith liked to take care of, and they were too young to come see him off. As they settled into the car, Keith looked out the window.

“You won’t be too far from home, okay?” Keith nodded and thanked his social worker. As long as Keith could find where the desert was, he wouldn’t try to run away.

* * *

His foster family was just a man and woman. They’d had foster children before, and Keith wasn’t put off by their scent when they came to visit him initially. He didn’t want to call them by their names, and he’d never call them his parents. Seeing them on their doorstep, waiting for him, Keith felt his heart pick up in speed.

“I’ll do my best,” he whispered to his rabbit. The social worker opened the door for him, inviting him to start his new life.

“You’ll do great, Keith. I believe in you.”

* * *

“I heard you like animals, Keith,” his foster parent, Hisa, commented, putting some mashed potatoes on the boy’s plate. Keith nodded, staring at the cup of juice that her husband, Ray, had poured for him already.

“I do, Aunt Hisa.” Hisa began to talk about going to the zoo, something that Keith had seen in films before. He nodded when Hisa mentioned going to see the wolves and birds. He was going to ask if they were in the same exhibit, but Ray interrupted her with information about the weather.

“Did you hear about that heat wave coming in?

“Heat wave?”

“Yes, Keith,” Hisa said, “It’s supposed to get up to 104 degrees outside, which can be dangerous even with the shade that’s coming too.”

“... Is that Fahrenheit?”

Ray stared at Keith for a moment.

“Yes. Do you use Celsius?”

“That’s what I heard the most when I was little,” Keith explained, making a little mound of potatoes on his spoon.

Hisa pulled out her phone and hummed, announcing, “That’s about 40 degrees.”

Keith choked on his mashed potatoes, aghast. When he had lived in the desert, he’d always gone inside when the thermometer read 37 degrees, since he couldn’t always find water outside. He would go under the floorboards to the Cellar and sleep there.

“People go outside when it’s that hot?”

“There are inside exhibits, Keith. We don’t have to if you’re not comfortable with the heat.”

Keith nibbled at the inside of his lower lip.

“Don’t people get awful thirsty?”

“Yeah, but there are fountains all over the zoo where we can fill up our water bottles.” Ray gave Keith a smile, saying, “Don’t worry, Keith. It’ll be alright.”

Keith nodded, sipping at his juice and trying not to choke on it.

* * *

The zoo trip was a success. Keith had never been in a car for so long before. The highway was so long and the city of Tucson was bigger than any movie city. The zoo had so many animals and plants. Keith had never seen so many different animals, at least not in real life. He didn’t know that so many birds were in different colors or that so many plants were growing and could grow in just one place if they were taken care of well.

He got to see stingrays. They reminded him of aliens with their upside-down and flattened faces. Hisa gave him some of the food that they had bought. Under the watch of the animal caretaker, Keith put his hand in the water. A stingray came right over, its fins gliding through the water. Keith let a small laugh bubble out of him when the wet smoothness of the ray’s mouth tickled his fingers.

Seeing the ocelots and bobcats had Keith purring softly to himself the rest of the day, so soft that Hisa and Ray couldn’t hear. When he looked over the side of a bridge, looking down at one of the ocelots, she had looked up and followed his steps. She was a beautiful cat, almost as pretty as the one that had nursed him in the desert when he had started to starve one day after wandering too far from the shack. Hisa and Ray got him a sweet slush drink that made his head hurt before seeing the other exhibits. 

In terms of enjoyment, Keith actually had a very fun day.

Days afterward were spent getting used to the daily routine. Hisa had taken time off to help Keith get ready for the school year that was starting a few weeks after he was fostered. Keith had never been, but the psychiatric home and the group home had schedules structured on schools, or so the doctors said. He knew that he’d have classes or be in a classroom all day, go for recreational activities, and he’d have a break for lunch.

“What else is at school, Aunt Hisa? Aside from learning?”

“Well, they’ll want you to be good in the classroom. I know you haven’t been around too many children your age, but you’ll learn how to interact with them.”

Keith’s brow furrowed.

“Am I really different from kids my age?”

“Most kids your age haven’t been on their own as long as you were. Some kids might not know what it’s like to not have their mother or father with them.” Hisa petted Keith’s hair, smiling as he closed his eyes to focus on whatever thought was crossing his mind.

“You’ll do well. Just… try to be patient.”

Keith pouted up at her from his spot on the floor, laying his head on his knees. He was used to chairs, but he liked his spot on the ground and on shelves. The shelves, he already understood that he probably shouldn’t do, just to make other people more comfortable, even if it was a better viewing point.

… That was probably why he shouldn’t do it, since it was a viewing point for survival, for hunting. On the ground, at least he could make a getaway, like the Flash in those old cartoons.

“I’m almost nine. Will other kids almost be nine?”

“They might have just turned eight.”

“Do they really serve things that can’t be identified?”

Hisa laughed, shaking her head. She hadn’t heard of that in years, not since she had seen those older movies where teenagers complained about lunch food. She explained that to Keith, who looked up at her, rapt.

“That makes me feel better.”

“If you want, I can make your lunch for the first few days until we get a schedule down and I can help you make your own.”

Keith nodded, his chin now on his knees. That was a good plan. It’d make his school days easier.

* * *

There were so many kids. Keith wished he was that Austrian actor, so he could just tower above everybody. Why were most of the kids taller than him? At his desk, in which he placed his new notebooks, pens, pencils, and eraser, he was surrounded on all sides. There were girls on all sides of him, talking with each other and other students. He nibbled at the inside of his lips, controlling his breathing and reminding himself that it was just the first day of school.

Keith looked down at the gloves that he had on. Aunt Hisa said that they could be worn today, but he would have to get used to touching things again, like when he’d have to give handshakes.

“Okay, class,” the teacher yelled. The volume made Keith want to cover his ears, but he didn’t. It wasn’t hurting him, Keith told himself; it was just loud, and the teacher continued, “Now, we are going to introduce ourselves to the class, alright? Just say your name, when your birthday is, and something interesting about yourself.”

“What counts as interesting?” one girl asked.

“Well,” the teacher said, smiling, “for example: I like hiking.”

“What’s hiking?” someone called.

“Hiking is taking a long walk. What’s nice about it is that my husband and I usually go up to the mountains to hike. From there, we can see from the mountain down below.”

Keith raised his hand, wanting to ask about what the teacher had seen in the mountains and where she had gone.

“Yes… Keith?” The teacher smiled at him, eyes sparkling. “Did you want to go first?”

Oh… He didn’t expect that.

“Um, I had a question, but I can.”

“Go ahead.”

“M-My name is Keith. I was wondering what mountains you go to.”

“I’ve hiked up Camelback Mountain, not too far from Phoenix here in Arizona.” The teacher smiled at him. “Keith, when’s your birthday?”

“My birthday is the 23rd of October… I like animals.”

“What’s your favorite animal, Keith?” Keith pondered the question for a moment.

“I like all animals, but I used to have a pet rabbit.”

A girl turned to him, voice excited and loud as she speaks: “That’s neat! Was it a girl or boy rabbit?”

“What’s your name, dear?” The teacher trying to move the day along, began to go through the classroom but not before thanking Keith and asking the class to thank him. Keith nodded. Each student was thanked.

When they were done, the teacher began to go over the daily schedule before starting some of the curriculum.

Keith found himself learning a lot about his classmates, about the world that day. It was a good day.

* * *

Keith had never had an assigned play time before. He also had never had to stay in a penned-in place, which made him nervous but at least he could see through the fence.

“Why do you have those marks on your face?” Keith looked over at the child that followed him onto the jungle gym. The boy pointed to his own cheeks. Keith knew that he had marks on his face, just like his Ma did. Pa had always said that he looked nice with them.

“I was born with them.”

“Really?”

Keith nodded, reaching the top of the jungle gym. He found a spot to sit down. The boy sat one level lower. Keith could smell the boy’s anxiety about going up any higher.

“They used to be a lot darker, but now they’re fading away.”

“Why?”

“Because I’m getting bigger.”

“Huh.”

* * *

Every day, Keith found himself excited to go to school. He was getting good grades and he was getting used to how loud everyone could be. During recess, he would go play on the jungle gym; no-one minded if he was at the top, pretending he was back in the desert with the mountain lions, just for a little while. Aunt Hisa helped him make his lunches in the evening, and Uncle Ray would pick him up from school, helping him with his homework if necessary.

One day, Uncle Ray talked to Keith about joining a club or sport.

“Is martial arts an okay sport, Uncle Ray?”

“Of course!” Ray patted Keith’s head, looking down at the algebra that the boy was working on. Keith was showing work on another piece of paper before he would staple the worksheet and homework answer sheet together.

“Pa taught me tae kwon do and some aikido.”

“Well, we’ll look for a class, then,” Ray said, “Would it be okay if I joined you?”

Keith smiled before going back to his worksheet. He was getting good grades and learning so much. He wanted to keep on going.

* * *

In October, every classroom was getting ready for Halloween. Keith learned about making Jack-o'-lanterns, carefully moving a carving blade. He thought it was kind of dumb. He'd never cut himself with his mother's knife or any hunting knife, but other kids weren't good with knives, he guessed. supposed.

This morning, Uncle Ray had left early for work. Yesterday, Keith had been told to take the bus in the morning, which was an occasional occurrence. Aunt Hisa had given him extra cookies in his  _ bento  _ box and said that they had something planned for the evening, as a small family.

Keith wondered why today was different.

“Everyone,” the teacher called, “we’ll put your pumpkins in the hallway in our display, so everyone can see your creations! On Halloween, we’ll place lights inside so that the older students coming in the evening for their events can see them.

“Now, we have a birthday today,” she announced. She moved one of the digital boards aside, revealing a “Happy Birthday” that was a permanent part of the classroom. Right where a few names had been already this year, was Keith’s name.

… He was nine today.

Last year, Keith had been in the hospital. He’d gotten a small cupcake and got to have ice cream and pick out a group activity. He used his “Free Day” pass that he’d earned for good behavior and they all voted to watch a film.

The two birthdays before, he’d been alone with the mountain lions outside, so he had spent the days in a dark cavern with a special friend and Sego for company.

Keith felt his eyes burn, the scent of a cornbread loaf and rabbit stew invading his memories. He could hear Sego’s music playing something slow. He could hear his Pa’s voice as he sang, their movements as Pa would hold Keith in his arms, dancing. For his first five birthdays, they would dance together and sing.

The class was wishing him a happy birthday. The girl next to him named Jenny was smiling widely at him and offering the birthday card that every student got. Keith shakily reached out to it, the glitter covered cardstock slightly coarse on his fingers. 

A shadow came across his desk. Keith looked up, his teacher’s smile on her face looking more concerned and interested in him than usual.

“Thank you,” he said softly. His teacher bent down to be a bit closer to his eye level. Keith liked that about her.

“Did you forget it was your birthday?”

“... Yes, ma’am.”

“How could you forget your own birthday?”

“Peter,” the teacher chided not unkindly, “sometimes we get so busy that we forget things like our birthdays. Sometimes adults forget how old they are!”

The children began to talk about things that they forgot, but Jenny was staring at him with intent. Keith began to clench and relax his fists intermittently. He loathed being stared at; it reminded him of how the mountain lions would stare at their prey, setting his instincts into overdrive in case he would have to run away.

“Okay, class. We are going to have a little bit of free time before lessons while I give Keith his birthday bag!” His teacher had Keith stand up, going to her desk and opening the drawer with little trinkets and sweets inside. As the class became abuzz with noise, Keith kept his breathing slow and even. He counted just the way his thought-doctor taught him for his nervousness.

“Keith, would you want to stay inside for recess?”

Keith nodded, holding his bag to his chest.

“Honey, what’s wrong?” Keith’s teacher was told of a few things, Keith knew, but she didn’t know about what happened to Pa, Keith’s life in the desert, or Doe. She certainly didn’t know about Blue.

“... I live with Uncle Ray and Aunt Hisa now. I… I miss my Pa.”

His teacher nodded, stretching out her arms to him.

“Would you like a hug, Keith?”

Keith tilted his head, trying to remember when someone he didn’t know would give him hugs. The nurses at the hospitals always gave him hugs when he hadn’t been talking to them. When he had learned that Pa had… that Pa had died, Dr. Magdalena would hug him every time that they saw each other. She was his doctor now, so it happened whenever he went for a check-up. Aunt Hisa and Uncle Ray would hug him when he’d come back from school and when they’d come home from work..

How would Keith return the hug?

He leaned into his teacher’s hug, laying his head on her chest to hear her heartbeat. Her arms were so warm around him. He could hear her heart pumping slowly, though it seemed to be beating kind of hard.

“Let’s start class for the day, Keith,” his teacher cooed softly to him, “and when we have recess, we can stay inside. You get your cupcake at lunchtime.”

“Thank you.”

* * *

Aunt Hisa and Uncle Ray had a small cake for him when he got home. It wasn’t everyday that both of them would be at home before him.

“Happy birthday, Keith!” Uncle Ray picked him up, holding him tightly. Keith returned the hold, as he had learned. Uncle Ray always held him when he seemed to want a hug back.

“You’re nine years old today, sweetheart!”

Aunt Hisa looked at him expectantly. Keith smiled, reaching out for her. Aunt Hisa kissed his cheeks before Uncle Ray set him down. 

“Let’s blow out your candles, okay?”

Keith looked at the cake, reading his name and the words “Happy birthday” on it. There were nine candles, just like in the movies. He looked to Aunt Hisa, who was already grabbing a camera.

“Smile, honey!”

Keith did his best as the camera flashed its bright light at him. Bright, fake lights always seemed to hurt his eyes. After his eyes readjusted, Keith rubbed his eyes a bit.

“Sorry, kiddo.”

“I’m okay.”

Keith knelt up on the chair, following their instructions to blow out the candles as Uncle Ray lit them and then turned off the lights.

“You said you’ve watched this on TV, right?”

“Yes… I make a secret wish.”

“That’s right. Go ahead, Keith!”

Keith took a deep breath and blew out as hard as he could, the candles’ flames disappearing and plunging the room in the dark. It created a tickling sensation in his chest.

This was something new that he was feeling. Even as Aunt Hisa and Uncle Ray were looking to turn on the lights, Keith could feel that feeling grow. This was a happiness that he had not felt in years.

The piece of cake that was cut for him was tasteless in his mouth. The frosting was sticky. He knew that there was sugar and chocolate in it, that he should enjoy it, but it felt… wrong.

Why was he celebrating when his Pa was gone?


End file.
